Provider Demographics
NPI:1811991425
Name:MACKAY, CECILIA CRUZ (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:CRUZ
Last Name:MACKAY
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15901 CENTRAL COMMERCE DR
Mailing Address - Street 2:STE 301
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-2044
Mailing Address - Country:US
Mailing Address - Phone:512-251-7775
Mailing Address - Fax:512-251-7776
Practice Address - Street 1:15901 CENTRAL COMMERCE DR
Practice Address - Street 2:STE 301
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-2044
Practice Address - Country:US
Practice Address - Phone:512-251-7775
Practice Address - Fax:512-251-7776
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19892235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist